During the first year of the pandemic, a minimum of 13.8% of the patients had encountered the virus and the rate of developing postoperative symptomatic Covid-19 was 6.3% including a patient with full-blown Covid-19 pneumonia 1 day after SG. Results on weight loss matched expectations.
Currently, differing from the first peak of pandemic, vaccines are underway although a more serious surge continues. Given the high rate of morbidity and mortality of Covid-19 infection early after elective operations, caution is warranted when balancing the expected benefit from an elective procedure against the risk of acquiring perioperative Covid-19 infection.
Currently, differing from the first peak of pandemic, vaccines are underway although a more serious surge continues. Given the high rate of morbidity and mortality of Covid-19 infection early after elective operations, caution is warranted when balancing the expected benefit from an elective procedure against the risk of acquiring perioperative Covid-19 infection.To assess efficacy and safety of percutaneous cryoablation (CA) for advanced and refractory extra-abdominal desmoid tumors.
This retrospective study reviewed 30 consecutive patients with symptomatic desmoid tumors evolving after "wait and watch" periods, and despite medical treatment, treated by CA between 2007 and 2019. Progression free survival (PFS), objective response rate, pain reduction (decreased of visual analogic scale pain (VAS)[Formula see text] 3 or disappearance of pain), total volume lesion (TVL) and complications were documented. Kaplan Meier method was used to outline PFS. Paired sample t test was used to compare volume of tumors before treatment and at 1 and 3year.
With a median follow-up of 18.5months (range 6-93months, interquartile range (IQR) 12-55), the PFS was 85.1% at 1year and 77.3% at 3years. Objective response was obtained for 80% of patients with a complete response for 43% patients. Pain reduction was obtained for 96.7% (95% confidence interval (95% CI) 90.3, 100) of patients. https://www.selleckchem.com/products/d-luciferin.html Median volume of desmoid tumor before treatment was 124.1cm(range 2-1727cm, IQR 54-338cm). Median change of TLV after ablation was 66.6% (95% CI 37.2, 72.3; p?=?0.002) at 1year and 76.4% (95% CI 59.1, 89.8; p?=?0.002) at 3year. Adverse events rate was 36.6%, the most common was edema and temporary increase of pain in the days following CA. Four patients experienced a major complication (13.3%) 2 skin necrosis, 1 infection and 1 brachial plexopathy.
CA is an effective treatment for advanced and refractory extra-abdominal desmoid tumor, that induces durable responses.
CA is an effective treatment for advanced and refractory extra-abdominal desmoid tumor, that induces durable responses.Considering that thickened liquids are frequently used for patients with dysphagia, elucidating their impact on laryngeal dynamics is important. Although studies have investigated the impact of thickened liquids on laryngeal movement velocity among healthy young adults, no study has examined the same among patients with dysphagia. We aimed to elucidate the influence of bolus consistency on laryngeal movement velocity and surface electromyographic activity of the suprahyoid muscles in patients with dysphagia. Participants included 18 male, poststroke patients with dysphagia, whereas patients with true bulbar paralysis, head and neck cancer, neuromuscular disease, or recurrent nerve paralysis were excluded. A video fluoroscopic swallowing study (VFSS) was performed while swallowing 3 mL of moderately thick and thin liquids. Quantitative VFSS analysis, including factors such as laryngeal peak velocity, laryngeal mean velocity, laryngeal movement distance, duration of the laryngeal elevation movement, and the temporal location of laryngeal vestibule closure within the laryngeal elevation movement was performed. Muscle activity was evaluated using integrated muscles activity values obtained from electromyography (iEMG) of the suprahyoid muscle during swallowing. VFSS analysis showed that laryngeal peak velocity and laryngeal mean velocity were significantly faster while swallowing moderately thick than while swallowing thin liquids. Laryngeal movement distance was significantly greater while swallowing moderately thick than while swallowing thin liquids. iEMG was significantly higher while swallowing moderately thick liquids than while swallowing thin liquids. Compared to thin liquids, moderately thick induced an increase in laryngeal movement velocity and in suprahyoid muscle activity among patients with dysphagia, a finding consistent with that of a previous study among healthy adults.The MD Anderson Dysphagia Inventory (MDADI) is a 20-item dysphagia-specific QOL questionnaire with four subscales global, emotional, functional, and physical. It is widely used in clinical practice and in research; however, its psychometric properties have been under-researched. We aim to evaluate the organisation of the MDADI subscales and identify any redundant items. The MDADI is a routinely collected outcome measure at two centres in northeast England. Questionnaires completed at three months following treatment were extracted from these existing databases. Factor analysis was carried out with the aim of reducing redundancy among the set of questionnaire items. Cases with missing values were excluded. A total of 196 complete patient questionnaires were used in factor analysis. A one-factor model accounted for around 50% of the total variance in item responses. The top five endorsed items (abbreviated by the questionnaire item keywords Excluded, Irritate, Esteem, Social, and Why) in this one factor appeared in three (emotional, functional, and physical) of the four supposed MDADI subscales, i.e. global, emotional, functional, and physical. Our results suggest an overlap of three MDADI subscales across the top five endorsed items. The content of the top five questions all appear related to the psychosocial aspects of swallowing. This implies some redundancy of the items in the original subscales of the questionnaire. Using the most endorsed items, it appears feasible to abbreviate the 20-item MDADI questionnaire to a 5-item "MiniDADI" questionnaire, which is likely to have greater utility in routine clinical practice outside of research settings.